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Packagemyhie.v4
Resource TypeQuestionnaire
Idq-maternal-18.R4.json
FHIR VersionR4

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Source1

{
  "resourceType": "Questionnaire",
  "id": "q-maternal-18",
  "url": "http://fhir.hie.moh.gov.my/Questionnaire/q-maternal-18",
  "version": "1.0.0",
  "name": "QMaternal18",
  "title": "Senarai Semak Risiko VTE Semasa Hamil dan Puerperium",
  "status": "active",
  "date": "2024-02-12T04:04:09.5621857+00:00",
  "description": "Reference: Prevention & Treatment of Thromboembolism in Pregnancy and Puerperium, 2018",
  "purpose": "*Note: Thromboprophylaxis is recommended during the transient period. Consider stopping once the transient risks are deemed no longer significant.",
  "code": [
    {
      "code": "q-maternal-18"
    }
  ],
  "item": [
    {
      "linkId": "maternal-18.1",
      "code": [
        {
          "code": "maternal-18.1"
        }
      ],
      "prefix": "1",
      "text": "VTE risk factor",
      "type": "choice",
      "answerOption": [
        {
          "valueCoding": {
            "code": "00",
            "display": "Pre pregnancy/Booking"
          }
        },
        {
          "valueCoding": {
            "code": "01",
            "display": "Admission New Illness"
          }
        },
        {
          "valueCoding": {
            "code": "02",
            "display": "Post Delivery"
          }
        }
      ]
    },
    {
      "linkId": "maternal-18.2",
      "code": [
        {
          "code": "maternal-18.2"
        }
      ],
      "prefix": "2",
      "text": "Pre-existing risk factors",
      "type": "group",
      "item": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 4
            }
          ],
          "linkId": "maternal-18.2.1",
          "code": [
            {
              "code": "maternal-18.2.1"
            }
          ],
          "prefix": "2.1",
          "text": "Previous VTE (VTE Score - 4)",
          "type": "boolean"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 3
            }
          ],
          "linkId": "maternal-18.2.2",
          "code": [
            {
              "code": "maternal-18.2.2"
            }
          ],
          "prefix": "2.2",
          "text": "High risk thrombophilia (VTE Score - 3)",
          "type": "boolean"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 3
            }
          ],
          "linkId": "maternal-18.2.3",
          "code": [
            {
              "code": "maternal-18.2.3"
            }
          ],
          "prefix": "2.3",
          "text": "Medical comorbidities (VTE Score - 3)",
          "type": "boolean"
        },
        {
          "linkId": "maternal-18.2.4",
          "code": [
            {
              "code": "maternal-18.2.4"
            }
          ],
          "prefix": "2.4",
          "text": "Obesity",
          "type": "choice",
          "answerOption": [
            {
              "valueCoding": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
                    "valueDecimal": 2
                  }
                ],
                "system": "http://fhir.hie.moh.gov.my/CodeSystem/maternal-record-my-core",
                "code": "00",
                "display": "BMI ≥40kg/m2 (VTE Score - 2)"
              }
            },
            {
              "valueCoding": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
                    "valueDecimal": 1
                  }
                ],
                "system": "http://fhir.hie.moh.gov.my/CodeSystem/maternal-record-my-core",
                "code": "01",
                "display": "BMI 30-39kg/m2 (VTE Score - 1)"
              }
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 1
            }
          ],
          "linkId": "maternal-18.2.5",
          "code": [
            {
              "code": "maternal-18.2.5"
            }
          ],
          "prefix": "2.5",
          "text": "Family history of VTE (VTE Score - 1)",
          "type": "boolean"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 1
            }
          ],
          "linkId": "maternal-18.2.6",
          "code": [
            {
              "code": "maternal-18.2.6"
            }
          ],
          "prefix": "2.6",
          "text": "Low risk thrombophilia (VTE Score - 1)",
          "type": "boolean"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 1
            }
          ],
          "linkId": "maternal-18.2.7",
          "code": [
            {
              "code": "maternal-18.2.7"
            }
          ],
          "prefix": "2.7",
          "text": "Current smoker >10 per day (VTE Score - 1)",
          "type": "boolean"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 1
            }
          ],
          "linkId": "maternal-18.2.8",
          "code": [
            {
              "code": "maternal-18.2.8"
            }
          ],
          "prefix": "2.8",
          "text": "Gross varicose veins(VTE Score - 1)",
          "type": "boolean"
        }
      ]
    },
    {
      "linkId": "maternal-18.3",
      "code": [
        {
          "code": "maternal-18.3"
        }
      ],
      "prefix": "4",
      "text": "Obstetric risk factors",
      "type": "group",
      "item": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 2
            }
          ],
          "linkId": "maternal-18.3.1",
          "code": [
            {
              "code": "maternal-18.3.1"
            }
          ],
          "prefix": "3.1",
          "text": "Caesaren section (emergency & elective) (VTE Score - 2)",
          "type": "boolean"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 1
            }
          ],
          "linkId": "maternal-18.3.2",
          "code": [
            {
              "code": "maternal-18.3.2"
            }
          ],
          "prefix": "3.2",
          "text": "Pre eclampsia (VTE Score - 1)",
          "type": "boolean"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 1
            }
          ],
          "linkId": "maternal-18.3.3",
          "code": [
            {
              "code": "maternal-18.3.3"
            }
          ],
          "prefix": "3.3",
          "text": "IVF (1st trimester risk only) (VTE Score - 1)",
          "type": "boolean"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 1
            }
          ],
          "linkId": "maternal-18.3.4",
          "code": [
            {
              "code": "maternal-18.3.4"
            }
          ],
          "prefix": "3.4",
          "text": "Rotational instrumental delivery (VTE Score - 1)",
          "type": "boolean"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 1
            }
          ],
          "linkId": "maternal-18.3.5",
          "code": [
            {
              "code": "maternal-18.3.5"
            }
          ],
          "prefix": "3.5",
          "text": "PPH (>100mls) or requires blood transfusion (VTE Score - 1)",
          "type": "boolean"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 1
            }
          ],
          "linkId": "maternal-18.3.6",
          "code": [
            {
              "code": "maternal-18.3.6"
            }
          ],
          "prefix": "3.6",
          "text": "Stillbirth (current) (VTE Score - 1)",
          "type": "boolean"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 1
            }
          ],
          "linkId": "maternal-18.3.7",
          "code": [
            {
              "code": "maternal-18.3.7"
            }
          ],
          "prefix": "3.7",
          "text": "Prolonged labour (>24 hours) (VTE Score - 1)",
          "type": "boolean"
        }
      ]
    },
    {
      "linkId": "maternal-18.4",
      "code": [
        {
          "code": "maternal-18.4"
        }
      ],
      "prefix": "4",
      "text": "Transient risk factors",
      "type": "group",
      "item": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 4
            }
          ],
          "linkId": "maternal-18.4.1",
          "code": [
            {
              "code": "maternal-18.4.1"
            }
          ],
          "prefix": "4.1",
          "text": "Surgical procedures (excluding episiotomy, 1st & 2nd degree perineal repair, evacuation of products of conception) (VTE Score - 4)",
          "type": "boolean"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 4
            }
          ],
          "linkId": "maternal-18.4.2",
          "code": [
            {
              "code": "maternal-18.4.2"
            }
          ],
          "prefix": "4.2",
          "text": "Hyperemesis gravidarum / OHSS (VTE Score - 4)",
          "type": "boolean"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 1
            }
          ],
          "linkId": "maternal-18.4.3",
          "code": [
            {
              "code": "maternal-18.4.3"
            }
          ],
          "prefix": "4.3",
          "text": "Systemic/ Postpartum infection (VTE Score - 1)",
          "type": "boolean"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 1
            }
          ],
          "linkId": "maternal-18.4.4",
          "code": [
            {
              "code": "maternal-18.4.4"
            }
          ],
          "prefix": "4.4",
          "text": "Immobility Dehydration/ Admission beyond 3 days (VTE Score - 1)",
          "type": "boolean"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 1
            }
          ],
          "linkId": "maternal-18.4.5",
          "code": [
            {
              "code": "maternal-18.4.5"
            }
          ],
          "prefix": "4.5",
          "text": "Long distance travel (> 4hours) (VTE Score - 1)",
          "type": "boolean"
        }
      ]
    },
    {
      "linkId": "maternal-18.5",
      "code": [
        {
          "code": "maternal-18.5"
        }
      ],
      "prefix": "5",
      "text": "Total score",
      "type": "quantity"
    }
  ]
}